USPTO Patents Application 10033305

PTO/SB/06 (12-04)
Approved for use through 7/31/2O06. 0MB 0651-0032
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
Under the Paperwork Reduction Act of 1995, no persons ate required to respond to a collection of Information unless It displays a valid OMB control number

PATENT APPLICATION FEE DETERMINATION RECORD

Substitute for Form PTO-875

Application

APPLICATION AS FILED •

(Column 1)

PART I

(Column 2)

FOR

NUMBER FILED .

NUMBER EXTRA

BASIC FEE

(37CFR 1.16(a), (b), or (c)) .

SEARCH FEE

(37 CFR 1.16(k), (i), or(m))

EXAMINATION FEE
(37 CFR 1.16(0), (p), or (q))

TOTAL CLAIMS
(37 CFR 1.16(1))

minus 20 ~

INDEPENDENT CLAIMS
(37 CFR 1.16(h))

minus 3 s

•

APPLICATION SIZE
FEE

(37 CFR 1.16{s))

If the specification and drawings exceed 100
sheets of paper, the application size fee due
Is $250 ($125 for small entity) for each
additional 50 sheets or fraction thereof. See
35 U.S.C. 41(a)(1)(G) and 37 CFR 1.16(8).

MULTIPLE DEPENDENT CLAIM PRESENT (37 CFR 1.16(D)

k If the difference In column 1 is less than zero, enter "0" In column 2.
^ APPLICATION AS AMENDED - PART II

(Column 1) (Column 2) (Column 3)

CLAIMS
REMAINING

AFTER
AMENDMENT

HIGHEST
NUMBER
PREVIOUSLY
PAID FOR

PlteSENr
EXTRA I

MEt

Total

(37 CFR 1.16(|))

Minus

.MEND

Independent

(37 CFR 1.16(h))

Minus

- iip

° I

Application Size Fee (37 CFR*1.16(s))

RRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR 1.16(D)

(Column 1)

(Column 2)

(Column 3)

4

H

T

CLAIMS
REMAINING

AFTER
AMENDMENT

HIGHEST
NUMBER
PREVIOUSLY
PAID FOR

PRESENT
EXTRA

»MEI

| Total
(37 CFR 1.160))

*

Minus

**

s

MEND

Independent

(37 CFR 1.16(h))

*

Minus

•**

Application Size Fee (37 CFR 1.16(s))

<

FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR 1.16(D)

SMALL ENTITY

OR

DATE /«\

rtfc

X 25-

M

TOTAL

' SMALL ENTITY

RATE ($)

ADDI-
TIONAL
FEE ($)

x/^ll =

|rt>

TOTAL
ADD'L FEE

tfb

OR

OR

OR
OR

OR
OR

RATE ($)

ADDI-
TIONAL
FEE($)

X =

X =

TOTAL
ADD'L FEE

OR
OR

OR
OR

OTHER THAN
SMALL ENTITY

RATE ($)

x<5? ■

TOTAL

OTHER THAN
SMALL ENTITY

RATE ($)

TOTAL
ADD'L FEE

ADDI-
TIONAL

RATE ($)

TOTAL
ADD'L FEE

* If the entry In column 1 1s less than the entry in column 2, write "0" in column 3.
- If the "Highest Number Previously Paid For IN THIS SPACE is less than 20, enter -20".
>** If the "Highest Number Previously Paid For IN THIS SPACE is less than 3, enter "3".

The "Highest Number Previously Paid For (Total or Independent) is the highest number found in the appropriate box in column 1.

ADDI-
TIONAL
FEE ($)

This collection of information Is required by 37 CFR 1.16. The information is required to obtain or retain a benefit by the public which is to file (and by the
USPTO to process) an application. Confidentiality is governed by 35 U.S.C. 122 and 37 CFR 1.14. This collection is estimated to take 12 minutes to complete,
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arid Trademark Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313-1450. DO NOT SEND FEES OR COMPLETED FORMS TO THIS
ADDRESS. SEND TO: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450.

If you need assistance in completing the form, call 1-S00-PTO-9199 and select option Z